Insurance Fraud NEWS
Home-health agency to repay $14M for Massachusetts billings
December 06, 2017, Springfield, MA
A national home-health care agency that operates out of several locations in Massachusetts including Springfield has agreed to pay a $14 million settlement to end charges that it was paid for improper claims filed with MassHealth.
The settlement between Centrus Premium Home Care Inc. and the state of Massachusetts was announced Tuesday by state Attorney General Maura Healey.
Centrus operates in Massachusetts as Maxim Healthcare Services Inc., and operates from 6 locations in Massachusetts: Springfield, Worcester, Taunton, Needham, Plymouth and Wilmington.
According to Healey, the company billed MassHealth for services that were not eligible under state regulations for reimbursement.
"Home health agencies must be diligent in their billing practices to preserve the integrity of this program, which provides critical health care services to low-income individuals across our state," she said.
MassHealth was alerted to the problem last fall when Maxim submitted disclosure for over-payment and sought reimbursement. The disclosure revealed that claims were improperly submitted but were paid anyway for home health aide services that were not necessary.
MassHealth contacted the Attorney General's Medicaid Fraud Division in January 2017 regarding the matter, and it launched an investigation., Healey said.
The investigation found that between March 2010 and October of last year, Maxim submitted and received payment for nearly 95,000 claims for services that were not covered per MassHealth regulations.
The settlement requires Maxim to pay $14,264,803 to MassHealth. The company is also required to provide annual written certification to the Attorney General's Office of Compliance, and to provide training to all billing employees for proper procedures.
Source: Mass Live